COMPARISON OF RDUFKNTANIL IN COMBINATION WITH ISOFLURANE VERSUS PROPOFOL FOR SPONTANEOUS VRNJTILATION ANAESTHESIA IN DAY CASE SURGERY'

Abstract

ftemifentanil hydrochloride is a new, ultrashort-acting opioid metabolized by nonspecific plasma and tissue esterases. There are a few data in the literature that describe the use of remifentanil when administered as a

component of an inl1alational or total intravenous (TIVA) anesthetic techniques.

We studied 100 spontaneously breathing patients (using LMA) of both sex aged 20-40 years, ASAI-II, undergoing lower abdominal surgery (inguinal hemia repair, varicocele, testicular exploration etc ... ) or arthroscopic knee or ankle surgery of average 20-60 minutes duration with premedication by 2mg midazolam IV. Patients were randomized to receive a remifentanil loading dose of 0.5J..lg/kg followed by a continuous infi.Jsion of 0.2J..lg/kg/min in combination with isoflurane (MAC 1%) (group I, n=50) or propofol (initial• infusion rate of 9 mg/kg/h reduced to 6mg/kg;11 after l 0 mim tes), (group II, n=50). At the insertion of last surgical suture, the remifentanil and concomitant anesthetic were switched off simultaneously. There was no respiratory depression in both studied groups, recovery is more rapid in group I, incidence of nausea was more in group I, both groups showed stable haemodynamic profile with attenuation of stress response but a plan of postoperative analgesia was required.